2015-11-09T09:10:03-06:00 2014-12-31 521446779 JOHNSON LAMBERT LLP 700 SPRING FOREST ROAD STE 115 RALEIGH NC 27609 990 2014-01-01 061555320 ALLIANCE OF NONPROFITS FOR INSURANCE RISK RETENTION GROUP INC ALLI 8314590980 PO BOX 8507 SANTA CRUZ CA 950618546 KIM ADAY CFO, TREASURER 8314590980 2015-11-02 1 JOHN HUSKINS P01081531 9197196400 2015-11-09 2014 2016-04-25 22:37:26Z X PAMELA DAVIS 333 FRONT STREET STE 200 SANTA CRUZ CA 95060 41442615 0 X WWW.INSURANCEFORNONPROFITS.ORG X 1999 VT QUALIFIED CHARITABLE RISK POOL FOR NONPROFIT ORGANIZATIONS. 11 10 0 0 0 0 0 0 19160099 23631985 1246907 1402428 0 0 20407006 25034413 0 0 0 0 0 0 0 0 0 19612642 24224114 19612642 24224114 794364 810299 86422567 102554077 59347589 74023439 27074978 28530638 X ALLIANCE OF NONPROFITS FOR INSURANCE, RISK RETENTION GROUP, INC. (ANI) IS A CHARITABLE RISK POOL WHOSE PURPOSE IS TO PROVIDE AFFORDABLE, APPROPRIATE, STABLE, AND SPECIALIZED INSURANCE COVERAGES TO OTHER 501(C)(3) NONPROFIT ORGANIZATIONS AND TO DEVELOP AND DELIVER TRAINING AND PRODUCTS TO ASSIST THESE ORGANIZATIONS TO PROVIDE THEIR SERVICES EFFECTIVELY AND EFFICIENTLY WHILE MINIMIZING THE FREQUENCY AND SEVERITY OF ACCIDENTS AND INJURY TO OTHERS DURING THE DELIVERY OF THEIR SERVICES TO OUR COMMUNITIES. 0 0 23347900 23631985 PROVIDED 5,483 501(C)(3) ORGANIZATIONS WITH A STABLE SOURCE OF REASONABLY PRICED LIABILITY INSURANCE TAILORED TO THE SPECIALIZED NEEDS OF THE NONPROFIT SECTOR. 201751 ASSISTED NONPROFIT ORGANIZATIONS WITH DEVELOPMENT AND IMPLEMENTATION OF SUCCESSFUL LOSS CONTROL AND RISK MANAGEMENT PROGRAMS BY PROVIDING LOSS CONTROL PUBLICATIONS, EMPLOYEE HANDBOOK REVIEWS, PRE-TERMINATION LEGAL CONSULTATIONS, DEFENSIVE DRIVER TRAINING, CHILD SEXUAL ABUSE PREVENTION TRAINING, AND ACCESS TO EMPLOYMENT BACKGROUND CHECK SERVICES. 23549651 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 271 0 1 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X X KIMBERLY ADAY CFO & TREASURER 8314590980 333 FRONT STREET SANTA CRUZ CA 95060 WILSON JONES CHAIRMAN 1.00 2.00 X X 0 0 0 PAMELA DAVIS PRESIDENT 14.00 26.00 X X 0 443174 28475 STEPHEN SUMNER SECRETARY 1.00 2.00 X X 0 0 0 STEVEN RICHARD SECRETARY (TO AUG '14) 1.00 2.00 X X 0 0 0 ANDREW SARGEANT ASSISTANT SECRETARY 1.00 1.00 X X 0 0 0 DAVID ALTMAN DIRECTOR (TO FEB '14) 1.00 X 0 0 0 R LAWRENCE BACON DIRECTOR 1.00 3.00 X 0 0 0 GLEN CASEL DIRECTOR (FROM AUG '14) 1.00 X 0 0 0 NORRIS CLARK DIRECTOR 1.00 1.00 X 0 0 0 BERNADETTE MADDOX DIRECTOR (FROM FEB '14) 1.00 X 0 0 0 MARTHA MARCON DIRECTOR 1.00 3.00 X 0 0 0 TED VAN NAME DIRECTOR 1.00 X 0 0 0 MICHELLE UCHIYAMA DIRECTOR 1.00 X 0 0 0 KIM ADAY CFO, TREASURER 14.00 26.00 X 0 292419 26992 0 735593 55467 0 0 1 0 MARSHALL DENNEHEY WARNER COLEMAN & GOGGI 2000 MARKET ST SUITE 2300 PHILADELPHIA PA 19103 CLAIMS LEGAL FEES 305251 BARBER MCCASKILL JONES & HALE PA 400 W CAPITOL AVENUE SUITE 2700 LITTLE ROCK AR 72201 CLAIMS LEGAL FEES 304670 MARGOLIS EDELSTEIN 170 S INDEPENDENCE MALL W SUITE 4 PHILADELPHIA PA 19106 CLAIMS LEGAL FEES 201035 SCHWED KAHLE & KRESS PA 11410 NORTH JOG ROAD SUITE 100 PALM BEACH GARDENS FL 33418 CLAIMS LEGAL FEES 148615 THATCHER LAW FIRM LLC 7849 BELLE POINT DRIVE GREENBELT MD 20770 CLAIMS LEGAL FEES 147672 12 NET EARNED PREMIUM 524298 23441377 23441377 PROGRAM SERVICE FEES 524298 190608 190608 23631985 1229584 1229584 16581046 16408202 172844 172844 172844 25034413 23631985 0 1402428 X 2679698 2542149 137549 74533 74533 41061 41061 35506 35506 88261 88261 4021066 3964604 56462 2289 2289 49745 1493 48252 64888 3670 61218 13695 13695 40001 40001 LOSS AND LOSS ADJUSTMEN 16668388 16668388 PREMIUM TAXES 1015195 1015195 LICENSES & FEES 42284 420 41864 DEFERRED ACQUISITION CO -683029 -683029 70533 36761 33772 24224114 23549651 674463 0 9105902 8483614 10592397 13294584 5748662 7420117 42209345 48612571 18766261 24743191 86422567 102554077 586899 604515 58760690 73418924 59347589 74023439 X 6000000 6000000 2000000 2000000 19074978 20530638 27074978 28530638 86422567 102554077 X 810299 818205 -172844 X 0 1 X 1 0 X 11505825 12588223 14585336 19160099 23631985 81471468 11505825 12588223 14585336 19160099 23631985 81471468 171761 173225 140442 149708 176997 812133 972854 1133998 1230684 1145502 1746450 6229488 1144615 1307223 1371126 1295210 1923447 7041621 74429847 1349104 1318624 1233997 1109287 1229584 6240596 1349104 1318624 1233997 1109287 1229584 6240596 12854929 13906847 15819333 20269386 24861569 87712064 0.84860 0.83650 0.07110 0.08300 X 0 0 0 0 0 0 1 35506 0 0 35506 0 PART II-B, LINE 1: ANI'S BOARD HAS CONCLUDED THAT TO BE ABLE TO PROVIDE ITS MEMBERS WITH THE INSURANCE PRODUCTS THEY NEED TO OPERATE AS EFFECTIVELY AND EFFICIENTLY AS POSSIBLE, ANI NEEDS TO HAVE THE AUTHORITY TO PROVIDE PROPERTY INSURANCE TO ITS MEMBERS, IN ADDITION TO THE LIABILITY INSURANCE IT ALREADY PROVIDES. THAT REQUIRES AN AMENDMENT TO THE LIABILITY RISK RETENTION ACT, A FEDERAL LAW. TO ALLOW ANI TO BETTER SERVE OUR MEMBERS, ANI'S CEO HAS BEEN MEETING WITH MEMBERS OF CONGRESS TO ENCOURAGE THEM TO SUPPORT THE PROVISIONS OF H.R. 3794 (INTRODUCED IN THE 114TH CONGRESS). 0 REINSURANCE RECOVERABLE 24467458 INTEREST RECEIVABLE 275733 24743191 LOSS & LOSS ADJUSTMENT RESERVES 54261528 UNEARNED PREMIUM RESERVE 17519074 PAYABLE TO AFFILIATES 552451 REINSURANCE PAYABLE 1085871 73418924 X 25764357 818205 818205 24946152 88261 88261 25034413 24135853 0 24135853 88261 88261 24224114 PART X, LINE 2: MANAGEMENT CONCLUDED THAT THE COMPANY HAS PROPERLY MAINTAINED ITS EXEMPT STATUS AND THAT NO UNCERTAIN TAX POSITIONS EXIST AS OF DECEMBER 31, 2014. 0 0 0 0 0 0 0 0 0 PAMELA DAVIS PRESIDENT 0 329980 0 97224 0 15970 0 15300 0 13175 0 471649 0 0 KIM ADAY CFO, TREASURER 0 256223 0 36263 0 -67 0 15300 0 11692 0 319411 0 0 FORM 990, PART VI, SECTION A, LINE 6 ORGANIZATIONS INSURED BY ANI ARE MEMBERS OF THE ORGANIZATION, AND ARE ENTITLED TO ONE VOTE EACH ON MATTERS SUBMITTED TO THE MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7A ANI MEMBER ORGANIZATIONS ELECT THE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B A VOTE OF TWO-THIRDS OF THE MEMBERS IS REQUIRED TO MERGE OR DISSOLVE THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 WILL BE MADE AVAILABLE ELECTRONICALLY TO THE ANI MANAGEMENT, OFFICERS, AND BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS AND OFFICERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY. THESE FORMS ARE REVIEWED BY THE CHAIRMAN OF THE AUDIT COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 ANI GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND FORM 990 ARE AVAILABLE ON IT'S WEBSITE AS WELL AS UPON REQUEST. FORM 990, PART IX, LINE 11G COMMISSIONS: PROGRAM SERVICE EXPENSES 3,964,604. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,964,604. ACTUARIAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 42,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,000. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 14,462. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,462. FORM 990, PART XI, LINE 9: CHANGE IN OTHER COMPREHENSIVE INCOME -172,844. ALLIANCE MEMBER SERVICES 333 FRONT STREET STE 200 SANTA CRUZ CA 95060 061555318 SUPPORTING ORGANIZATION VT 501(C)(3) 11 I N/A 0 NATIONAL ALLIANCE OF NONPROFITS FOR INSURANCE 333 FRONT STREET STE 200 SANTA CRUZ CA 95060 061555321 CHARITABLE RISK POOL VT 501(C)(3) 9 N/A 0 NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA 333 FRONT STREET STE 200 SANTA CRUZ CA 95060 770203935 CHARITABLE RISK POOL CA 501(C)(3) 9 N/A 0 AMS INSURANCE SERVICES PO BOX 8507 SANTA CRUZ CA 95061 770513798 INSURANCE BROKER CA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0